目的探讨扩散加权成像(DWI)、灌注加权成像(PWI)以及两者联合对幕上毛细胞型星形细胞瘤(PA)与WHO 2级多形性黄色星形细胞瘤(PXA WHO 2级)的鉴别诊断价值。资料与方法回顾性分析2010年1月—2022年2月于福建医科大学附属第一医院经手术和...目的探讨扩散加权成像(DWI)、灌注加权成像(PWI)以及两者联合对幕上毛细胞型星形细胞瘤(PA)与WHO 2级多形性黄色星形细胞瘤(PXA WHO 2级)的鉴别诊断价值。资料与方法回顾性分析2010年1月—2022年2月于福建医科大学附属第一医院经手术和病理证实的23例幕上PA及11例PXA WHO 2级的常规MRI、DWI及PWI资料,并将幕上PA根据病灶部位进一步分为脑叶型PA与非脑叶型PA,对比两组基本资料(性别、年龄、囊变、均匀强化、病灶大小和是否累及脑膜)、最小表观扩散系数、相对表观扩散系数及相对最大脑血容量。结果PXA WHO 2级出现软脑膜受累的概率(36.3%)高于幕上PA(4.3%,P=0.029);PXA WHO 2级分别与幕上PA、脑叶型PA相比,最小表观扩散系数、相对表观扩散系数均较低,相对最大脑血容量较高(t=-4.398~5.828,P均<0.05)。最小表观扩散系数鉴别幕上PA与PXA WHO 2级的阈值为1.09×10^(-3) mm^(2)/s,敏感度、特异度和曲线下面积分别为90.91%、83.33%和0.947;当相对最大脑血容量的鉴别诊断阈值为1.79时,敏感度、特异度和曲线下面积分别为90.00%、100.00%和0.950。DWI联合PWI的曲线下面积为0.993,与单独使用DWI及PWI对比,均未提高诊断效能(Z=1.371、0.928,P均>0.05)。亚组分析中,脑叶型PA与PXA中DWI联合PWI的曲线下面积为0.988,分别与DWI及PWI对比,均未提高诊断效能(Z=1.322、0.882,P均>0.05)。结论DWI、PWI均有助于PXA WHO 2级与幕上PA、脑叶型PA的鉴别诊断,但DWI联合PWI未显著提高鉴别诊断效能。展开更多
Background: The irrational use of medicines remains a key health problem in many developing countries. The overuse of antibiotics is a key driver of antimicrobial resistance (AMR). This study surveyed antibiotic use a...Background: The irrational use of medicines remains a key health problem in many developing countries. The overuse of antibiotics is a key driver of antimicrobial resistance (AMR). This study surveyed antibiotic use and adherence to the World Health Organization (WHO) prescribing indicators at the Request Muntanga Hospital in the Kalomo District of Southern Province, Zambia. Materials and Methods: This cross-sectional study was conducted from July 2023 to September 2023 at Request Muntanga Hospital in Zambia and reviewed 600 medical record prescriptions which were issued from July 1, 2022 to June 30, 2023 using the WHO prescribing indicators. The collected data were analyzed using Statistical Package for Social Sciences version 23.0. Results: From the 600 prescriptions sampled, 1246 medicines were prescribed, with antibiotics making up 86.7% of the encounters. Additionally, the average number of drugs prescribed per encounter was 2.1 and the prevalence of polypharmacy was 61.3%. Further, 17.8% of medicines were prescribed as injectables. Furthermore, 76.7% of the drugs were prescribed from the Zambia Essential Medicines List and 38.9% by generic names. Conclusions: This study found a high use of antibiotics and deviations from the WHO/International Network of Rational Use of Drugs (INRUD) core prescribing indicators at the Request Muntanga Hospital indicating non-adherence to the prescribing indicators. There is a need to promote adherence to the WHO/INRUD core prescribing indicators to promote the rational use of antibiotics and prevent the emergence and spread of AMR.展开更多
目的对应用核心行为测试组合（Neurobchavioral Core Test Battery,NCTB）方法进行噪声对神经影响流行病学调查的文献进行Meta-分析,用NCTB法确定噪声对神经系统的影响及可能的作用阈值.方法应用Meta-分析方法的Stouffer法和Winnner法,...目的对应用核心行为测试组合（Neurobchavioral Core Test Battery,NCTB）方法进行噪声对神经影响流行病学调查的文献进行Meta-分析,用NCTB法确定噪声对神经系统的影响及可能的作用阈值.方法应用Meta-分析方法的Stouffer法和Winnner法,对《中国生物医学文献数据库》及《中文生物医学期刊文献数据库》的相关文献进行分析.结果噪声接触确实可以使人的负性情绪增多,比较不同噪声水平的结果显示,80～85dB（A）时,噪声即可对工人的神经系统产生较大影响,＞90dB（A）组用Winnner法计算的检验值Uc和Stouffer法计算的检验值Zc均高于80～85dB（A）组.噪声接触使工人的数字跨度、数字译码、视觉记忆、目标追踪等得分减少,并且在＞90dB（A）组,这种降低程度更明显.结论在80～85dB（A）时,噪声即可对工人的神经系统产生较大影响,并提示可能存在剂量-效应关系.展开更多
由于过去十几年间对肺癌认识的巨大发展,尤其是在肿瘤内科学、分子生物学和放射学等领域的发展,迫切需要一个不仅病理学而是整合多学科研究成果的肺癌新分类。因此,刚刚出版的2015世界卫生组织(World Health Organization,WHO)肺、胸膜...由于过去十几年间对肺癌认识的巨大发展,尤其是在肿瘤内科学、分子生物学和放射学等领域的发展,迫切需要一个不仅病理学而是整合多学科研究成果的肺癌新分类。因此,刚刚出版的2015世界卫生组织(World Health Organization,WHO)肺、胸膜、胸腺和心脏肿瘤分类与2004 WHO分类相比有很多重要变化。新版分类在促进学科领域发展、影响学科研究、优化患者治疗和辅助评估预后方面都有显著提升。文章简要介绍重要变化如下:(1)2011国际肺癌研究协会/美国胸科学会/欧洲呼吸学会(International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society,IASLC/ATS/ERS)分类推荐的腺癌分类主要变化;(2)将鳞状细胞癌重新分类为角化型、非角化型和基底样亚型,非角化型需免疫组化证明有鳞状分化;(3)严格限定大细胞癌的诊断只能在切除标本中做出,并对其进行瘦身,原大细胞癌分类中仅保留缺乏任何明确形态和免疫组化分化的部分;(4)将神经内分泌肿瘤划分到同一分类下;以及(5)目前对肺癌组织学分级的观点。展开更多
文摘目的探讨扩散加权成像(DWI)、灌注加权成像(PWI)以及两者联合对幕上毛细胞型星形细胞瘤(PA)与WHO 2级多形性黄色星形细胞瘤(PXA WHO 2级)的鉴别诊断价值。资料与方法回顾性分析2010年1月—2022年2月于福建医科大学附属第一医院经手术和病理证实的23例幕上PA及11例PXA WHO 2级的常规MRI、DWI及PWI资料,并将幕上PA根据病灶部位进一步分为脑叶型PA与非脑叶型PA,对比两组基本资料(性别、年龄、囊变、均匀强化、病灶大小和是否累及脑膜)、最小表观扩散系数、相对表观扩散系数及相对最大脑血容量。结果PXA WHO 2级出现软脑膜受累的概率(36.3%)高于幕上PA(4.3%,P=0.029);PXA WHO 2级分别与幕上PA、脑叶型PA相比,最小表观扩散系数、相对表观扩散系数均较低,相对最大脑血容量较高(t=-4.398~5.828,P均<0.05)。最小表观扩散系数鉴别幕上PA与PXA WHO 2级的阈值为1.09×10^(-3) mm^(2)/s,敏感度、特异度和曲线下面积分别为90.91%、83.33%和0.947;当相对最大脑血容量的鉴别诊断阈值为1.79时,敏感度、特异度和曲线下面积分别为90.00%、100.00%和0.950。DWI联合PWI的曲线下面积为0.993,与单独使用DWI及PWI对比,均未提高诊断效能(Z=1.371、0.928,P均>0.05)。亚组分析中,脑叶型PA与PXA中DWI联合PWI的曲线下面积为0.988,分别与DWI及PWI对比,均未提高诊断效能(Z=1.322、0.882,P均>0.05)。结论DWI、PWI均有助于PXA WHO 2级与幕上PA、脑叶型PA的鉴别诊断,但DWI联合PWI未显著提高鉴别诊断效能。
文摘Background: The irrational use of medicines remains a key health problem in many developing countries. The overuse of antibiotics is a key driver of antimicrobial resistance (AMR). This study surveyed antibiotic use and adherence to the World Health Organization (WHO) prescribing indicators at the Request Muntanga Hospital in the Kalomo District of Southern Province, Zambia. Materials and Methods: This cross-sectional study was conducted from July 2023 to September 2023 at Request Muntanga Hospital in Zambia and reviewed 600 medical record prescriptions which were issued from July 1, 2022 to June 30, 2023 using the WHO prescribing indicators. The collected data were analyzed using Statistical Package for Social Sciences version 23.0. Results: From the 600 prescriptions sampled, 1246 medicines were prescribed, with antibiotics making up 86.7% of the encounters. Additionally, the average number of drugs prescribed per encounter was 2.1 and the prevalence of polypharmacy was 61.3%. Further, 17.8% of medicines were prescribed as injectables. Furthermore, 76.7% of the drugs were prescribed from the Zambia Essential Medicines List and 38.9% by generic names. Conclusions: This study found a high use of antibiotics and deviations from the WHO/International Network of Rational Use of Drugs (INRUD) core prescribing indicators at the Request Muntanga Hospital indicating non-adherence to the prescribing indicators. There is a need to promote adherence to the WHO/INRUD core prescribing indicators to promote the rational use of antibiotics and prevent the emergence and spread of AMR.
文摘目的对应用核心行为测试组合（Neurobchavioral Core Test Battery,NCTB）方法进行噪声对神经影响流行病学调查的文献进行Meta-分析,用NCTB法确定噪声对神经系统的影响及可能的作用阈值.方法应用Meta-分析方法的Stouffer法和Winnner法,对《中国生物医学文献数据库》及《中文生物医学期刊文献数据库》的相关文献进行分析.结果噪声接触确实可以使人的负性情绪增多,比较不同噪声水平的结果显示,80～85dB（A）时,噪声即可对工人的神经系统产生较大影响,＞90dB（A）组用Winnner法计算的检验值Uc和Stouffer法计算的检验值Zc均高于80～85dB（A）组.噪声接触使工人的数字跨度、数字译码、视觉记忆、目标追踪等得分减少,并且在＞90dB（A）组,这种降低程度更明显.结论在80～85dB（A）时,噪声即可对工人的神经系统产生较大影响,并提示可能存在剂量-效应关系.
文摘由于过去十几年间对肺癌认识的巨大发展,尤其是在肿瘤内科学、分子生物学和放射学等领域的发展,迫切需要一个不仅病理学而是整合多学科研究成果的肺癌新分类。因此,刚刚出版的2015世界卫生组织(World Health Organization,WHO)肺、胸膜、胸腺和心脏肿瘤分类与2004 WHO分类相比有很多重要变化。新版分类在促进学科领域发展、影响学科研究、优化患者治疗和辅助评估预后方面都有显著提升。文章简要介绍重要变化如下:(1)2011国际肺癌研究协会/美国胸科学会/欧洲呼吸学会(International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society,IASLC/ATS/ERS)分类推荐的腺癌分类主要变化;(2)将鳞状细胞癌重新分类为角化型、非角化型和基底样亚型,非角化型需免疫组化证明有鳞状分化;(3)严格限定大细胞癌的诊断只能在切除标本中做出,并对其进行瘦身,原大细胞癌分类中仅保留缺乏任何明确形态和免疫组化分化的部分;(4)将神经内分泌肿瘤划分到同一分类下;以及(5)目前对肺癌组织学分级的观点。
